People suffering mental health crisis are getting better care in Hertfordshire, thanks to progress of the partnership Concordat which was formed in October 2014. The agreement, signed by more than 20 organisations across the county, heralded the way for an action plan that is already making a difference.
Progress made includes the introduction of an advisory mental health nurse stationed in the police communications and control room, a ‘street triage’ pilot and specialist training instigated for frontline police officers. We have also seen the launch of ‘A Year of Mental Health’ in Hertfordshire to raise awareness and reduce the stigma and discrimination attached to the issue.
A website at http://www.crisiscareconcordat.org.uk/areas/hertfordshire/ shows Hertfordshire’s progress and its published action plan to improve care and support for those in mental health crisis. It also highlights good practice nationally, showing Hertfordshire at the forefront of conducting effective needs assessments which involve several partners working together and sharing appropriate and relevant information.

The county’s Concordat working group is concentrating on three key areas of housing, especially for those who are homeless; data sharing and reducing the use of the Section 136 (Mental Health Act) detention power, which can unnecessarily put people into ‘a place of safety’ when more appropriate and less intensive support may be required.

Following a successful pilot, the police Force Communications Room project has now been fully rolled out, with a member of Herts Partnership University NHS Foundation Trust’s (HPFT) Crisis Assessment and Treatment Team present seven days a week. A mental health clinician guides and supports police when they are called to an incident involving any person who may be under or in need of HPFT services and when considering use of the Section 136 (Mental Health Act) detention power.

They can also advise on welfare calls, missing people, service users causing concern about mental health issues in a non-public place and voluntary admission to A&E.

A street triage pilot, with police and a mental health worker, working together begins in North and East Herts shortly and the training of frontline police officers ensures they have a clinical perspective of mental health issues, information on the Mental Health Act and information about the support that HPFT can provide.

One of the 24 partner organisations is the Office of the Police and Crime Commissioner (OPCC) in Hertfordshire. OPCC Head of Policy and Engagement, Dr Amie Birkhamshaw, said: “The Concordat is making excellent progress and the Commissioner is very pleased to be playing a part in ensuring that those suffering a mental health crisis can more easily access the support and care they need. In the Police & Crime Plan, ‘Everybody’s Business’, the Commissioner has pledged to reduce the use of Section 136s and to strive to prevent those in mental health crisis being criminalised unnecessarily.

“Mental health issues can have a major impact on the safety of individuals and wider society so it is vital to have in place appropriate services with well-trained and knowledgeable experts to guide the process and provide support.”

Colette Wyatt-Lowe, Cabinet Member for Adult Care and Health at Hertfordshire County Council, said: “It’s great to see the development of support for people suffering mental health crises in Hertfordshire. It’s clear that the Concordat, and the organisations involved in supporting it, are making a difference.”

Research shows that, nationally, one in four people experience a mental health problem in any given year and many will come into contact with the police either as victims of crime, witnesses, offenders or when detained under Section 136 of the Mental Health Act. People with mental health problems are more likely to be victims of crime than others and up to 90 per cent of prisoners, and two fifths of those on community sentences, have mental health problems.

Detective Chief Inspector Fiona Gaskell, who leads on mental health issues for Hertfordshire Constabulary, said: “As police officers, we have a crucial role in working with and supporting people with mental health problems. We may be the first to respond to urgent situations and have to make quick decisions to assess the situation, as well as the needs of the individuals involved, ensuring their safety and that of the general public.
“The work of the Concordat is, therefore, very welcome and we will continue to work with our partners on improving care and support.”

All organisations involved have pledged to help people find the support they need from whichever service they turn to first. They will work together to prevent crises happening, through intervening at an early stage, and by looking together at the factors that contribute to crisis. The aim is to make sure that the needs of vulnerable people in urgent situations are met and they get the right care at the right time from the right people.
The local declaration and action plan forms part of a national agreement by the government and organisations committed to improving mental health care.

The Mental Health Crisis Care Concordat agreement was announced in Hertfordshire on Mental Health Awareness Day (14 October, 2014) and paved the way for a formal Crisis Care Concordat to be signed by all partners.

Partners in the Concordat are:
Office of the Hertfordshire Police and Crime Commissioner, Hertfordshire Health and Wellbeing Board, Hertfordshire Constabulary, Hertfordshire County Council, West Hertfordshire Hospitals NHS Trust, East and North Hertfordshire NHS Trust, East of England Ambulance Service, British
Transport Police, Hertfordshire Community NHS Trust, Hertfordshire Partnership NHS University Foundation Trust, National Probation Service, BeNCH Community Rehabilitation Company , Herts Valley CCG, East and North Hertfordshire CCG, ViewPoint (Improving mental health, drug and alcohol services in Hertfordshire) Carers in Hertfordshire, B3 Living, Making Carers Count, Healthwatch Hertfordshire, CRI, Turning Point and Mind in mid-Herts.

Mental Health Crisis Care Concordat: the joint statement
We commit to work together to improve the system of care and support so people in crisis because of a mental health condition are kept safe and helped to find the support they need – whatever the circumstances in which they first need help – and from whichever service they turn to first.
We will work together, and with local organisations, to prevent crises happening whenever possible through prevention and early intervention. We will make sure we meet the needs of vulnerable people in urgent situations. We will strive to make sure that all relevant public services support someone who appears to have a mental health problem to move towards Recovery.
Jointly, we hold ourselves accountable for enabling this commitment to be delivered across England.